Provider Demographics
NPI:1962153353
Name:THOMPSON, SUSAN (MS, LMHC, CPC, NCC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, LMHC, CPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 ASPEN PEAK LOOP APT 2921
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-1849
Mailing Address - Country:US
Mailing Address - Phone:206-551-1098
Mailing Address - Fax:
Practice Address - Street 1:701 ASPEN PEAK LOOP APT 2921
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-1849
Practice Address - Country:US
Practice Address - Phone:206-551-1098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP0295101YP2500X
WALH00005474101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional